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04-7820 (RER)o� o 7004 OFTt�'9 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253' BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760),777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application NumberX04-00007820 Date 12/15/04 Property Address . . . """51705- AVENIDA-VILLA . APN: 773-143-022-10 -000000- Application description REMODEL*"- RESIDENTIAL Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . . . 7500 Owner Contractor ----------------- COOK REBECCA CURTIS HEAT/AIR COND/PLBG, DAN 51-705 AVENIDA VILLA 100 SO. SUNRISE WAY, #295 LA QUINTA CA 92253 PALM SPRINGS CA 92262 (760) 831-9582 WCC: STATE FUND WC: 2290023742 11/01/05 CSLB: 78154:6 07/31/06 CCC:' C20 -C36 -----=-------------------- Structure Information ----------------------.--- Construction.Type . . .. TYPE V - NON RATED Occupancy. Type . . . . . DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2001 ---------------------------------------------------------------------------- Permit . . . . ELECT - ADD/ALT/REM Additional desc Permit Fee 26.00 Plan Check F=e 6.50 Issue Date . . Valuation 0 Expiration Date 12/15/05 Qty Unit Charge PerExtension BASE FEE 1:00 11.0000 EA ELEC MISC 11.00 Permit MECHANICAL Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date Valuation . . . 0 Expiration Date 12/15/05 Qty Unit Charge. Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ' 1.00 9.0000 EA MECH ADPL REP/ALT/ADD 9.00 Permit . . . . . . PLUMBING Additional desc Permit Fee . . 30.00 Plan Check Fee 6.38 Issue Date Valuation . . . 0. Expiration Date 12/15/05 ciF P.O. Box 1504 • ����� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Appncatlon Number: Applicant: . Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: -» Architect or Engineer: Architect or Engineer's A dress: Lic. No.. tsUILUING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class G'2..0 / [.3 Lo License No. Date V -L — Ao-- We Contractor 3i4 t C u tp---% 1 )c�} (o -NL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U 1 am exempt under Sec. , BA P.C. for this reason Date Owner ' WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the -performance of the work for which this permit is issued. My orkers' compensation insurance carrier and policy number argue Cartier �:�O.T�v1V0 Policy Number Z�-g mCZ S-iL}Z certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date_ Applicant_\ �\ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706, OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lenders Address IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT LICAN ACKNOWLEDGEMENT or aconditions and orth on this 1. Each person upon whose behalf this application is made, each person at Permit restrictions e r qu st a d for whose benefit worksorm rk perfo fed under or pulrsuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the ab ve-mentioned property for inspection purposes. Signature (Applicant or Agent . i' G •n, ' Page 2 Application Number ... 04-00007820 Date. 12/15/04 Qty Unit Charge Per Extension,' BASE FEE •15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER -INST/ALT/REP 3.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 Special Notes and Comments SFD - PLUMBING PERMIT FOR GAS PIPING AND METER TO 6 APPLIANCES. MECHANICAL AND ELECTRICAL PERMIT FOR HVAC UNIT CHANGE OUT. 2001 CODES. Fee summary Charged Paid Credited Due Permit Fee Total 89.00 .00 .00 89.00. Plan Check Total 21.13 .00 .00. 21.13 .Grand Total. 110.13 .00 .00 110.13 A`cLD ^acs �3A � � ����2� >!, ��;t:s!, ,.� ^ •�' CITYNOF LA n = ;UtLbt'r�INS & SAFETY PPR DEPT F TR ONS D.�CFION P BY .41 i 1©Svz �i,.Z•i�� � C1xasG LZ+2,��n,�cQ C�.S �►�R- �� ,� � s ...,..: ¢•i :i�u;rd aG•�.J�o_,c¢w: �. ..,.�iY.-I' .a.�+c+..n. d.s =.J7 •r �` 3 � ¢ +,Gad: 3 lz ."• ..� tTLl .41 i 1©Svz �i,.Z•i�� � C1xasG LZ+2,��n,�cQ C�.S �►�R- �� "AN ADEQUATELY SIZED DEBRIS CONTAINER IS �EQiJIRED ON THE JOB SITE DURING ALL PHASES OF CONSTRUCTION AND MUST BE A RE -INSPECTION FEE OF $30 EMPTYD AS NECESSARY FAILURE TO DO SO WILL BE CHARGED IF THE APPRWD MAY CAUSE THE CITY TO HAVE THE CONTAINER PLANS AND 108 CARD ARE MDT DUMPED AT THE EXPENSE OF THE OWNER/ ON THE SITE FOR A SCHEDULED CONTRACTOR." INSPECTION. NO D(CIINIONS1 Construction is - NOT PERMITTED on the following Code Holidays: Octcher l.st - Aprif 30 2 _y; tcia Friday: 7:00 a.m. to s: b0. .m: �+ New Year's Day S'=aturday: 8:00 a.m. to 5:00,P-111. , . Dr. -Martin Luther IGngJr. Day Sundav: None— Government Code Holidays:—Ngne_----�� president's Day �emOria[ Day May 1st - September 30th , `' ' Independence Day Monday - Friday: 6:00 a.m, to 7:00 p -an. ' Labor Da I ' y Saturday: 8:00 a.m. to 5:00 pmu Sunday: None Veteran's Day j' Government Code Holidays: None Thanksgiving Day` r ` Christmas Dayj fl N CUMIS PLUMBING • HEATING %SIR CONDITIONING i-ycn% 0114 _GARS �-Z-TN , v \NL-< DATE \ \ 2.� O -A CONTRACT MAILING ADDRESS: Imo. .100 South Sunrise Way, #295 [AMERICAN Palm Springs, .CA 92262-4467 EXPRESS (I CA St. Lic. #781546 C-20/C-36/HIC t�z ac�UU vr- 202-k e, __1 EPA Cert. #2048556 01210 W \r vvjlr W— . -- w•— - S ������-3.� �.-T-��w-- HR. EMERGENCY SERVICE C.Q FS (P�} �loZ-o:3 u SOLD TO: PHONE CDSPO) 5 ��'�� J.OB ADDRESS: PHONE If ) NAME e est*. C�\L NAMEZ \�c�� C40 -Ir- ADDRESS N%xc ADDRESS -20E, Avg - y `%- 'U CITY-�Fsiv��d4 STATE CO-- ZIP _ CITY STATE C=� ZIP O TECHNICIAN TEcHNl�cl�a�N DIAGNOSIS/SOLUTION +5 P�G vv.l j CwsLyic DISPATCH NUMBER TRK. NO.� ..,� L� Q L _ r+`Nc�c.� vJ >, t �-�� i`3} 5 rz cz: , t Q .� C.�aJ (S �� �� t v J5 �`� 'Fryer \� C..L.y 17Q C\.S2�,� VJ c L.� CZ- V� tQ. Wo (moi n �V�l L. i�7 Q -�� v �\ Lt p©d L.\ tJ,'� S \'`� e�D �SZ l '2-\ , <-c-'— v tj `• 'iL Ct YV� i�� \r vvjlr W— . -- w•— - S ������-3.� �.-T-��w-- HR. EMERGENCY SERVICE C.Q FS (P�} �loZ-o:3 u SOLD TO: PHONE CDSPO) 5 ��'�� J.OB ADDRESS: PHONE If ) NAME e est*. C�\L NAMEZ \�c�� C40 -Ir- ADDRESS N%xc ADDRESS -20E, Avg - y `%- 'U CITY-�Fsiv��d4 STATE CO-- ZIP _ CITY STATE C=� ZIP TECHNICIAN TEcHNl�cl�a�N DIAGNOSIS/SOLUTION +5 P�G vv.l j CwsLyic DISPATCH NUMBER TRK. NO.� ..,� L� Q L _ r+`Nc�c.� vJ >, t �-�� i`3} 5 rz cz: , t Q .� C.�aJ (S �� �� t v J5 �`� 'Fryer \� C..L.y 17Q C\.S2�,� VJ c L.� CZ- V� tQ. Wo (moi n �V�l L. i�7 Q -�� v �\ Lt p©d L.\ tJ,'� S \'`� e�D �SZ l '2-\ , <-c-'— 97 98 STANDARD WARRANTY IS 12 MONTHS ON LABOR AND PARTS UNLESS OTHERWISE NOTED HEREIN: (EXCLUDES STOPPAGES) tj `• 'iL Ct YV� i�� Qty 5i:'� :� �d� iZ- �� S ti � >,1.T� EL � y�"`L S L� A •t'ec�; '\��Q2. i�tZ oJ� � td. '�� It ..,.� P"�� a.. �>Q.,�4a't.�CL �1�..�1 %Z;6 <Ljc_ c\� Q \ o �o cz p / c.. �f� �e : c AAL ADDITIONAL REMARKSL��L WORK AUTHORIZATION PAYMENT OF THIS INVOICE / CONTRACT DUE UPON COMPLETION OF WORK AUTHORIZATION TO PROCEED WITH ABOVE DIAGNOSIS/SOLUTION • I, the undersigned. am ownar/authoriiad repro sentativetenant NOTES / TERMS of the premises at which the work mentioned above is to be done. I hereby authorize you to perforin Diagnosis/Solution, and to use such labor and materials as you deem advisable. A monthly service charge of 1 1/2% will be added atter 10 days. I agree to pay reasonable attorney's fees and court costs in the event of a legal action. If my check does not clear. I realize 1 could be liable for 3 times the amount of / the check. in no case more that $500 and in no case lass than $100 all set forth in California Civil Code Section 1719, plus the face value of Me check and court costs. I have read, agree to, and have received a copy of the contract and Notice to Owner end statement required on ` contract on reverse side. All parts will be removed from premises and discarded unless otherwise specified here�rN V LL �•`'�((.(�� c o. I hereby authorize you to proceed with the above work at the flat rate of $ \� Jo_ \, AUTHORIZED Xy JOB START- DATE COMPLETION DATE '1 S j `r` SIGNATURE ACCEPTANCE OF WORK PERFORMED I find the service and materials -1 CHECK t1 CREDIT CARD EXPIRATION DATE rendered and installed in connection with the above work mentioned. to have. 1 CASH ;1 NO. been completed in a satisfactory manner. I agree that the amount set forth on this E%P. cUsrONea contract in the space labeled "TOTAL" to be the total and complete flat AUTHORIZATION CODE DRIVERS LIC. NO. DATE ACCOUNT NO. sEAvicE FEP. rate/minimun charge. I agree to pay reasonable attorney's fees and court costs in the event of legal action. A monthly service charge of 1 U2% will be added after 10 days. I acknowledge that I have read and received a legible copy of this contract and have read the Notice to Owner. and statement required on contract I do hereby state that the above work has been installed in a workmanlike manner and to the applicable on reverse side. building Codes. ACCEPTANCE X SIGNATURE X SUPPLY A/C TEMP. _ — -- KRID A/C RETURN; TEMP. BRI 0 ' See "NOTICE TO OWNER" and Statement required on `7 contract on reverse side. . MINIMUM CHARGE • G� Date Service Technician Signature